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Health Plans Seek Supreme Court Review in ACA "Risk Corridors" Cases

Client Alert | 1 min read | 02.12.19

On February 4, several health plans (including C&M client Maine Community Health Options) filed petitions for certiorari at the U.S. Supreme Court, seeking review of the Federal Circuit’s opinion in the ACA “risk corridors” cases, which held that while the risk corridors program contained a mandatory payment obligation on the part of the Government, that payment obligation was temporarily suspended by appropriations riders that restricted HHS funds available to satisfy the obligation, even though the riders did not amend or repeal the statutory payment obligation and even though the health plans had already performed their own reciprocal obligations under the statute. The petitioners are seeking review of the Federal Circuit’s opinion on several grounds, including (i) the restriction of funds to an agency via appropriations rider does not extinguish a statutory payment obligation of the United States, (ii) a rider that does not by its terms repeal or amend a money-mandating statute cannot impliedly and retroactively extinguish the Government’s payment obligation. The Maine petition is linked here. 

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Client Alert | 7 min read | 01.30.26

CMS Proposes CY 2027 Growth Rate and Changes to Risk Adjustment for Medicare Parts C and D

On January 26, 2026, the Centers for Medicare and Medicaid Services (CMS) circulated the Calendar Year (CY) 2027 Advance Notice to communicate proposed changes to Medicare Advantage (MA) capitation rates and Parts C and D payment policies.  The changes are expected to be finalized in April 2026 but may be delayed. The following is a summary of the most significant proposals, with further details below:...